bloodjourГематология и трансфузиологияRussian journal of hematology and transfusiology0234-57302411-3042ООО Издательский дом «Практика»10.35754/0234-5730-2022-67-2-216-239bloodjour-364Research ArticleОБЗОРЫREVIEWSРоль интенсивной терапии при проведении трансплантации аллогенных гемопоэтических стволовых клетокRole of the intensive care in allogeneic hematopoietic stem cell transplantationhttps://orcid.org/0000-0002-7916-2322ЩекинаА. Е.ShchekinaA. E.

Щекина Антонина Евгеньевна, аспирант, врач-реаниматолог отделения реанимации и интенсивной терапии

125167, Москва

Antonina E. Shchekina, Postgraduate Student, Resuscitation and Intensive Care Department

125167, Moscow

shekina_ae@mail.ruhttps://orcid.org/0000-0001-8818-8949ГалстянГ. М.GalstyanG. M.

Галстян Геннадий Мартинович, доктор медицинских наук, заведующий отделом реанимации и интенсивной терапии

125167, Москва

Gennadiy M. Galstyan, Dr. Sci. (Med.), Head of the Resuscitation and Intensive Care Department

125167, Moscow

gengalst@gmail.comhttps://orcid.org/0000-0001-9431-8316ДроковМ. Ю.DrokovM. Y.

Дроков Михаил Юрьевич, кандидат медицинских наук, руководитель сектора по изучению иммунных воздействий и осложнений после ТКМ

125167, Москва

Mikhail Y. Drokov, Cand. Sci. (Med.), Head of the Sector for the Study of Immune Effects and Complications after BMT

125167, Moscow

mdrokov@gmail.comФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской ФедерацииРоссияNational Medical Research Center for HematologyRussian Federation202206072022672216239Copyright © Щекина А.Е., Галстян Г.М., Дроков М.Ю., 20222022Щекина А.Е., Галстян Г.М., Дроков М.Ю.Shchekina A.E., Galstyan G.M., Drokov M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.htjournal.ru/jour/article/view/364Введение

Введение. Проведение трансплантации аллогенных гемопоэтических стволовых клеток (алло-ТГСК) нередко сопровождается возникновением угрожающих жизни осложнений.

Цель — анализ причин возникновения и эффективности лечения угрожающих жизни осложнений, возникающих у реципиентов аллогенных гемопоэтических стволовых клеток (алло-ГСК).

Основные сведения

Основные сведения. В связи с развитием угрожающих жизни осложнений от 10 до 50 % реципиентов алло-ГСК нуждаются в переводе в отделение реанимации и интенсивной терапии (ОРИТ). Причинами госпитализации в ОРИТ являются острая дыхательная недостаточность, сепсис, реакция «трансплантат против хозяина», веноокклюзионная болезнь, тромботическая микроангиопатия, синдром высвобождения цитокинов, синдром приживления и др. Риск развития угрожающих жизни состояний зависит от режима кондиционирования, типа донора, источника трансплантата, гематологического статуса и коморбидности больных. Основными прогностическими факторами, определяющими неблагоприятный исход реципиентов алло-ГСК в ОРИТ, являются выраженность полиорганной дисфункции, потребность в проведении методов жизнеобеспечения.

Introduction

Introduction. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is often complicated by life-threatening conditions.

Aim — an analysis of the life-threatening complications in recipients of allogeneic hematopoietic stem cells (allo-HSCs)

Main findings

Main findings. From 10 to 50 % of allo-HSC recipients need to be admitted to the intensive care unit (ICU) due to the development of life-threatening complications. The reasons for ICU admission are acute respiratory failure, sepsis, graft-versus-host disease, veno-occlusive disease, thrombotic microangiopathy, cytokine release syndrome, engraftment syndrome, etc. Conditioning regimen, donor type, stem cell source, underlying disease state and patient comorbidity are the risk factors associated with development of life-threatening conditions. The main prognostic factors of unfavorable ICU outcomes in allo-HSC recipients are the severity of multiple organ dysfunction and the need for organ support.

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The authors declare that there are no conflicts of interest present.